Healthcare Provider Details

I. General information

NPI: 1952608002
Provider Name (Legal Business Name): ANIL KUMAR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/24/2011
Last Update Date: 02/24/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

98 W IMPERIAL DR
HARAHAN LA
70123-4739
US

IV. Provider business mailing address

98 W IMPERIAL DR
HARAHAN LA
70123-4739
US

V. Phone/Fax

Practice location:
  • Phone: 828-318-3333
  • Fax:
Mailing address:
  • Phone: 828-318-3333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number5053R
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: